In dementia care, behaviours that seem inappropriate or embarrassing can be difficult for families and caregivers to witness. This month, we explore how thoughtful use of medications, alongside compassionate care, can support both behaviour and dignity.
Henry’s Inappropriate Behaviours
“Henry’s” family noticed that he was acting in ways that drew negative attention at his care home. While these behaviours may have seemed deliberate, they were rooted in changes in the brain caused by dementia – specifically, in areas responsible for judgment and impulse control.
Staff’s Approach to Henry’s Behaviour
Henry’s comments and actions led to scolding from staff at his Day Program. The staff often responded by correcting him, telling him to “stop that,” or expressing frustration at his behaviour. While these reactions may feel like a natural way to manage challenging behaviour, they are not usually effective for someone living with moderate symptoms of dementia.
Since dementia changes often affects areas of the brain responsible for judgment and impulse control, Henry was not able to fully control or understand his comments. Scolding or raising one’s voice does not change the brain’s response. It can actually increase confusion, anxiety, or distress. These approaches can also be emotionally harmful and are inconsistent with respectful, person-centred care.
Instead of punishment, compassionate strategies that focus on understanding the meaning behind behaviour, setting gentle boundaries, and offering reassurance are more appropriate.
How Henry’s Family Took Action
Exploring other alternatives to manage Henry’s behaviour, the family consulted with his doctor. Henry was prescribed donepezil, a medication that helps increase acetylcholine in the brain.
Over time, the areas of his brain involved in judgment and decision-making began to function better, and his behaviour improved. The actions that once caused discomfort and embarrassment to others diminished, and Henry’s interactions became closer to his “normal” self prior to the cognitive changes.
Professional, Ethical and Moral Responsibility in Dementia Care
It’s important to remember that scolding or punishing a person living with symptoms of dementia can be harmful and may be a form of emotional abuse. Even when behaviours are difficult, dignity and respect must remain central. Medications like donepezil can be a helpful tool, but they are just one part of a compassionate care approach that includes understanding, patience, and supportive environments.
Cognitive decline impairs memory, judgment, impulse control, and the ability to understand social cues, meaning the person often cannot control or fully understand their behaviour.
Healthcare providers and caregivers not only have a professional, but also an ethical and moral obligation to care for individuals with respect, compassion, and dignity.
The Heart of Dementia Care
In supporting people living with dementia, it is important to recognize that the person affected is often not fully in control of their behaviour, which is why they are particularly vulnerable. Understanding that there are underlying causes for the behaviour, and approaching it with curiosity and a willingness to ask “why,” helps us uncover those causes and respond in ways that truly support the person.
In Henry’s case, his behaviour occurred early enough that he was still receptive to treatment, and with the right support and medication, it improved. The inappropriate behaviour stopped.
Repeating the same approach, the wrong approach, such as scolding the person, does not work; in fact, it can make things worse. It is always important to remember and remind ourselves that there is still a person behind the behaviour: someone with needs, emotions, and dignity.
Interventions, whether pharmacological or non-pharmacological, work best when they focus on comfort, safety, and quality of life, rather than simply trying to suppress actions. By approaching dementia care this way, we honor both the person and their lived experience.
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If you found this article helpful and if you’re worried about a loved one or a friend and aren’t sure where to turn, you’re not alone. We’re here to help! Reach out, and together we can brainstorm solutions tailored to your unique situation. Start by visiting our website at https://dementiasolutions.ca/private-consulting/ to schedule your free 20-minute consultation with one of our experienced Dementia Care Advisors. We’re here to support you every step of the way.
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DISCLAIMER:
This article is based on a true story; however, names, locations, and certain events have been altered to protect the privacy and confidentiality of the individuals involved. Any resemblance to actual persons, living or dead, or actual events is purely coincidental.
The contents of this blog are provided for information purposes only. They are not intended to replace clinical diagnosis or medical advice from a health professional.
